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It is suggested that the principal criterion to be employed as an indication for emergency operation in severe upper gastrointestinal hemorrhage is the rate of bleeding. If a patient is in shock on arrival at the hospital, or develops evidence of it while under treatment, he deserves the constant vigilance of a bedside team of internist and surgeon, and is preferably treated on the surgical wards. If the hemorrhage does not seem to be controlled with blood transfusions approximating 500 c.c. every eight hours, an emergency operation is to be considered very seriously. An exact knowledge of the source of the bleeding, determined by emergency x-ray examination if necessary, is a prerequisite for this type of surgery in order to prevent a useless operation.
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Hoerr, S. O., Dunphy, J. E., and Gray, S. J.: The Place of Surgery in the Emergency Treatment of Acute Massive, Upper Gastro-intestinal Hemorrhage, Surg., Gynec. & Obst. (In press).
☆Read at the meeting of the Society of University Surgeons, New Orleans, La., Jan. 29–31, 1948.
© 1948 Published by Elsevier Inc.